Ventricular rhythms

Question 1

what are 4 reasons the ventricles may assume pacing the heart

Answer 1

1. SA node fails to discharge
2. impulse from SA node is generated but is blocked
3. SA node discharges slower than ventricles
4. irritable site in a ventricle produces early beats

Question 2

what is the characteristics of a PVC

Answer 2

ECG: p waves are usually absent but could be retrograded
QRS is wide and bizzare
T wave is opposite to the deflection of the QRS

Question 3

how many PVS are considered Vtach

Answer 3

3 in a row

Question 4

monomorphic PVC’s

Answer 4

same morphology of the PVC originating from the same ectopic focus

Question 5

Polymorphic PVC

Answer 5

PVCs have different morphology coming from different foci

Question 6

interpolated PVCs

Answer 6

PVC occurs between two normally conducted QRS complexes without disturbing the normal cardiac cycle

Question 7

R on T

Answer 7

the PVC occurs on the T wave of the preceding heart beat during its refractory period

Question 8

Ventricular escape beat

Answer 8

occurs when the normal pacemakers faile and that ventricles take over as the pacemaker

Question 9

characteristics of ventricular escape beat

Answer 9

looks like a PVC but appears after a pause in the rhythm

Question 10

idioventricular rhythm

Answer 10

characterized by 3 or more consecutive ventricular escape beats

Question 11

why is the idioventricular rhythm a “lastditch effort”

Answer 11

because its associated with sever bradycardia and its the last effeort to maintain a heart beat

Question 12

what is the rate for an idioventricular rhythm>

Answer 12

20 - 24

Question 13

treatment for Idioventricular rhythm

Answer 13

• atropine
• transcutaneous pacing
• vasopressors such as dopamine and EPI

Question 14

Accelerated idioventricular rhythm (AIVR)

Answer 14

3 or more ventricular escape beats at a rate of 41- 120 and p waves are usually absent

Question 15

treatment for AIVR if symptomatic?

Answer 15

• atropine
• atrial pacing

Question 16

V-Tach

Answer 16

three or more PVCs in a row at arate of >100

Question 17

non sustained V-Tach

Answer 17

a short run lasting <30 seconds

Question 18

Sustained V-Tach

Answer 18

persists for >30 seconds and can occur with/with out a pulse

Question 19

torsades de points

Answer 19

a specific form of V-Tach that is pollymorphic and has a streamer pattern rhythm

Question 20

Causes of PEA with a Narrow QRS

Answer 20

usually due to a mechanical problem. etiology like tension PTX or cardiac tamponade

Question 21

Causes of PEA with Wide QRS complex

Answer 21

usueally a metabolic problem which are effecting the hearts electrical activity like hyperkalemia or sodium channel blocker toxicity